HESI NUR 209 Medical Surgical
Nursing II Questions and Answers
Practice Questions with Solutions
Newest | Already Graded A+
Infection Control & Immunology
Question 1: A client diagnosed with human immune deficiency
virus is concerned about getting opportunistic infections and asks
the nurse how to prevent them. Which interventions does the
nurse recommend to the client?
A. Clean toothbrushes once a week.
B. Bathe daily using an antimicrobial soap.
C. Eat salad at least once a day.
D. Wash dishes in cool water.
Answer: B. Bathe daily using an antimicrobial soap.
Rationale: Bathing daily and using an antimicrobial soap will help
decrease the risk for opportunistic infections by reducing the
number of bacteria found on the skin. Toothbrushes should be
cleaned daily through the dishwasher or by rinsing in liquid
laundry bleach. Salads and raw fruits and vegetables could be
contaminated and should be avoided. Dishes should be washed in
hot, soapy water or in a dishwasher.
,Question 2: Which factors are possible transmission routes for
human immune deficiency virus (HIV)? (Select all that apply.)
A. Breast-feeding
B. Anal intercourse
C. Mosquito bites
D. Toileting facilities
E. Oral sex
Answer: A, B, E. Breast-feeding, Anal intercourse, Oral sex
Rationale: HIV can be transmitted via breast milk from an
infected mother to the child. Anal intercourse not only allows
seminal fluid to make contact with the mucous membranes of the
rectum, but it also tears the mucous membranes, making infection
more likely. Oral sexual contact exposes the mucous membranes
to infected semen or vaginal secretions. HIV is not spread by
mosquito bites or by other insects. HIV is not transmitted by
casual contact, and sharing toilet facilities does not allow
transmission of HIV.
Pharmacology & Oncology
Question 3: When caring for a client receiving chemotherapy, the
nurse plans care during the nadir of bone marrow activity to
prevent which complication?
A. Drug toxicity
B. Polycythemia
C. Infection
D. Dose-limiting side effects
,Answer: C. Infection
Rationale: The lowest point of bone marrow function is referred
to as the nadir; risk for infection is highest during this phase. Drug
toxicity can develop when drug levels exceed peak concentrations.
Polycythemia refers to an increase in the number of red blood
cells; typically chemotherapy causes reduction of red blood cells
or anemia. Dose limiting side effects occur when the dose or
frequency of chemotherapy need to be altered or held, such as in
the case of severe neutropenia or neurologic dysfunction.
Question 4: A client has a neutrophil count of 500/mm3 after
completing chemotherapy. Which intervention is most important
for the nurse to implement?
A. Implement bleeding precautions.
B. Review needs for pneumococcal vaccine.
C. Assess vital signs every 4 hours.
D. Provide the client with protective isolation.
Answer: D. Provide the client with protective isolation.
Rationale: A neutrophil count of 500/mm3 indicates severe
neutropenia, placing the client at high risk for life-threatening
infections. Protective isolation (neutropenic precautions) is the
priority to prevent exposure to pathogens. Bleeding precautions
are for thrombocytopenia. Vaccines may be contraindicated
during severe immunosuppression.
Question 5: The oncology nurse is caring for a group of clients
receiving chemotherapy. The client with which sign/symptom is
displaying bone marrow suppression?
A. Hemoglobin of 7.4 and hematocrit of 21.8
, B. Potassium level of 2.9 mEq/L and diarrhea
C. 250,000 platelets/mm³
D. 5,000 white blood cells/mm³
Answer: A. Hemoglobin of 7.4 and hematocrit of 21.8
Rationale: Bone marrow suppression results in decreased
production of red blood cells (anemia), white blood cells
(leukopenia), and platelets (thrombocytopenia). A hemoglobin of
7.4 and hematocrit of 21.8 indicate significant anemia. Normal
platelet count is 150,000-400,000/mm³; 250,000 is normal. Normal
WBC is 5,000-10,000/mm³; 5,000 is within normal range.
Endocrine & Metabolic Disorders
Question 6: A client's lab findings indicate elevations in thyroxine
and triiodothyronine hormones. The nurse suspects that the client
may have hyperthyroidism. Which symptom is most often
associated with hyperthyroidism?
A. Atrophied thyroid gland.
B. Increased pulse rate.
C. Periorbital edema.
D. Diarrhea stools.
Answer: B. Increased pulse rate.
Rationale: Hyperthyroidism causes a hypermetabolic state
leading to tachycardia, palpitations, weight loss, heat intolerance,
and nervousness. An atrophied thyroid is seen in hypothyroidism.
Periorbital edema is associated with Graves' ophthalmopathy but
Nursing II Questions and Answers
Practice Questions with Solutions
Newest | Already Graded A+
Infection Control & Immunology
Question 1: A client diagnosed with human immune deficiency
virus is concerned about getting opportunistic infections and asks
the nurse how to prevent them. Which interventions does the
nurse recommend to the client?
A. Clean toothbrushes once a week.
B. Bathe daily using an antimicrobial soap.
C. Eat salad at least once a day.
D. Wash dishes in cool water.
Answer: B. Bathe daily using an antimicrobial soap.
Rationale: Bathing daily and using an antimicrobial soap will help
decrease the risk for opportunistic infections by reducing the
number of bacteria found on the skin. Toothbrushes should be
cleaned daily through the dishwasher or by rinsing in liquid
laundry bleach. Salads and raw fruits and vegetables could be
contaminated and should be avoided. Dishes should be washed in
hot, soapy water or in a dishwasher.
,Question 2: Which factors are possible transmission routes for
human immune deficiency virus (HIV)? (Select all that apply.)
A. Breast-feeding
B. Anal intercourse
C. Mosquito bites
D. Toileting facilities
E. Oral sex
Answer: A, B, E. Breast-feeding, Anal intercourse, Oral sex
Rationale: HIV can be transmitted via breast milk from an
infected mother to the child. Anal intercourse not only allows
seminal fluid to make contact with the mucous membranes of the
rectum, but it also tears the mucous membranes, making infection
more likely. Oral sexual contact exposes the mucous membranes
to infected semen or vaginal secretions. HIV is not spread by
mosquito bites or by other insects. HIV is not transmitted by
casual contact, and sharing toilet facilities does not allow
transmission of HIV.
Pharmacology & Oncology
Question 3: When caring for a client receiving chemotherapy, the
nurse plans care during the nadir of bone marrow activity to
prevent which complication?
A. Drug toxicity
B. Polycythemia
C. Infection
D. Dose-limiting side effects
,Answer: C. Infection
Rationale: The lowest point of bone marrow function is referred
to as the nadir; risk for infection is highest during this phase. Drug
toxicity can develop when drug levels exceed peak concentrations.
Polycythemia refers to an increase in the number of red blood
cells; typically chemotherapy causes reduction of red blood cells
or anemia. Dose limiting side effects occur when the dose or
frequency of chemotherapy need to be altered or held, such as in
the case of severe neutropenia or neurologic dysfunction.
Question 4: A client has a neutrophil count of 500/mm3 after
completing chemotherapy. Which intervention is most important
for the nurse to implement?
A. Implement bleeding precautions.
B. Review needs for pneumococcal vaccine.
C. Assess vital signs every 4 hours.
D. Provide the client with protective isolation.
Answer: D. Provide the client with protective isolation.
Rationale: A neutrophil count of 500/mm3 indicates severe
neutropenia, placing the client at high risk for life-threatening
infections. Protective isolation (neutropenic precautions) is the
priority to prevent exposure to pathogens. Bleeding precautions
are for thrombocytopenia. Vaccines may be contraindicated
during severe immunosuppression.
Question 5: The oncology nurse is caring for a group of clients
receiving chemotherapy. The client with which sign/symptom is
displaying bone marrow suppression?
A. Hemoglobin of 7.4 and hematocrit of 21.8
, B. Potassium level of 2.9 mEq/L and diarrhea
C. 250,000 platelets/mm³
D. 5,000 white blood cells/mm³
Answer: A. Hemoglobin of 7.4 and hematocrit of 21.8
Rationale: Bone marrow suppression results in decreased
production of red blood cells (anemia), white blood cells
(leukopenia), and platelets (thrombocytopenia). A hemoglobin of
7.4 and hematocrit of 21.8 indicate significant anemia. Normal
platelet count is 150,000-400,000/mm³; 250,000 is normal. Normal
WBC is 5,000-10,000/mm³; 5,000 is within normal range.
Endocrine & Metabolic Disorders
Question 6: A client's lab findings indicate elevations in thyroxine
and triiodothyronine hormones. The nurse suspects that the client
may have hyperthyroidism. Which symptom is most often
associated with hyperthyroidism?
A. Atrophied thyroid gland.
B. Increased pulse rate.
C. Periorbital edema.
D. Diarrhea stools.
Answer: B. Increased pulse rate.
Rationale: Hyperthyroidism causes a hypermetabolic state
leading to tachycardia, palpitations, weight loss, heat intolerance,
and nervousness. An atrophied thyroid is seen in hypothyroidism.
Periorbital edema is associated with Graves' ophthalmopathy but
